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Comparison of Respiratory Outcome between Sustained Lung Inflation and Intermittent Positive Ventilation in Preterm Infants Requiring Resuscitation at Birth
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作者 Lamiaa SH. Rehan Safaa A. ELMeneza Heba T. Okda 《Open Journal of Pediatrics》 2021年第1期125-134,共10页
<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing t... <strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing the need for intubation and subsequent respiratory support in the neonatal intensive care unit among preterm infants.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Aim of the Study:</span></b><span style="font-family:Verdana;"> To assess the ef</span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">cacy of initial sustained lung in</span><span style="font-family:Verdana;">fl</span><span style="font-family:Verdana;">ation compared to standard intermittent positive pressure ventilation</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(IPPV) in preterm infants who need resuscitation in delivery room. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This was prospective randomized observational study that was conducted in the delivery room and NICU of A</span><span style="font-family:""> </span><span style="font-family:Verdana;">in shames University hospital from February 2019 to September 2019. The study included 115 preterm infants between 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">32 weeks of gestation who needed resuscitation at delivery room. The infants were randomly allocated into 2 groups;SLI group: included the preterm infants who received the SLI at initial inflation pressure of 25 cm H</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">O for 15 seconds using the Neopuff/T piece. IPPV group: preterm infants who received standard resuscitation;IPPV using the self-inflating bag. The heart rate (HR), oxygen saturation (SpO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">), oxygen requirement, and intubation rate as well as need of surfactant in the delivery room were assessed. </span><span style="font-family:Verdana;">All cases were evaluated after admission to the NICU for the need of me</span><span style="font-family:Verdana;">chanical ventilation in the </span></span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">rst 72 hours of life, death in delivery room or NICU and for bronchopulmonary dysplasia or death at 36 weeks post menstrual age</span><span style="font-family:""> </span><span style="font-family:Verdana;">(PMA).</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The percentage of preterm infants who needed resuscitation was 25.5% from the total deliveries during the study period.</span><span style="font-family:""> </span><span style="font-family:Verdana;">56.5% of them received SLI and 43.4% received conventional IPPV. There were no significant differences between the studied groups regarding gestational age, birth weight.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Apgar score, heart rate,</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">oxygen saturation was not significantly in</span><span style="font-family:Verdana;">creased in the SLI group at fifth minutes of age. The percentage of infants</span><span style="font-family:Verdana;"> who </span><span style="font-family:Verdana;">needed further resuscitation was 20% in SLI group and 12% in the IPPV </span><span style="font-family:Verdana;">group. There were no significant differences in need for surfactant, CPAP or ventilator among the studied groups.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">There were no</span><span style="font-family:""> </span><span style="font-family:Verdana;">significant differences in relation to complications as BPD, air leak or retinopathy and death between the two groups.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that there was no advantage from use of SLI in delivery room using T-piece upon the conventional IPPV using self-inflating bag.</span> 展开更多
关键词 sustained lung inflation Preterm Infants RESUSCITATION Delivery Room Mechanical Ventilation T-Piece Resuscitator-Self Inflated Bag
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